• Ferenc Greksa, Kálmán Tóth, Mihály Boros, and Andrea Szabó.
• Szegedi Tudományegyetem, Általános Orvostudományi Kar Ortopédiai Klinika Szeged.
• Magy Seb. 2012 Aug 1; 65 (4): 178-83.

Introduction/AimsOur aim was to characterize the periosteal microvascular reaction induced by the destruction of endosteal vasculature by reaming, and to monitor the time sequence of the events. We have also compared the microcirculatory effects of different implant materials that are most frequently employed in human endoprosthetics.Materials And MethodsThe right tibia of male Wistar rats was reamed by microsurgical means and implanted with titanium, steel-alloy or polyethylene nails. Intravital videomicroscopic examinations of the anteromedial and anterolateral surfaces of the tibial periosteum were performed to evaluate the changes in the overall vascular and capillary densities. Microscopic mechanical tests were used to assess the stability of the implants. In control groups, reaming without nailing was performed and the microvascular changes were examined 6 and 12 weeks after surgery.ResultsReaming alone caused a significant increase in the vascular density of the anteromedial periosteum and a bilateral increase in capillary density. Vascular density at the anteromedial side was increased after all of the implant materials applied, while only polyethylene induced remarkable increases in the capillary and vascular densities at the anterolateral side. Furthermore, polyethylene did not bring about osseointegration.ConclusionsEnhanced periosteal angiogenesis could be demonstrated after 12 weeks following tibial reaming. The compensatory microvascular reactions evoked by destruction of endosteal microcirculation of long bones are not influenced by osseo-integrative implant materials, but materials of poor osseointegration properties induce considerable compensatory increases in the microvascular density of the periosteum.

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